Control of excessive perspiration by use of a topical formulation has long been a medical and social goal. Excessive sweating accounts for intertrigo, infection, dermatitis, and friction blisters of wet soles. It also results in disability for typing and writing due to dripping palms, being handicapped in sporting events from facial sweat, and having a compromised grip on baseball bats, tennis racquets, and basketballs. On the social side, hyperhidrosis induces the embarrassment of wet armpit clothing, gustatory sweating and auriculotemporal facial sweating (Frey's syndrome), and varied patches of nevoid localized sweating. All intertriginous areas, including fat folds and toe-webs, are susceptible to harm by unevaporated trapped sweat which induces maceration and leads to secondary bacterial and fungal infections. Add to this the cost of dry cleaning clothing and shoe replacement. Total localized control of sweating by topical means has thus been a long term medical objective.
The first commercial antiperspirant was introduced approximately 100 years ago. It was an aqueous-alcoholic solution of aluminum chloride hexahydrate with an effectiveness now estimated to be 60-70%. Through the century, the effectiveness of commercial antiperspirants has dropped to the 30-55% range due to the industry replacing aluminum chloride hexahydrate with weaker, more alkaline, less irritating salts of aluminum. Indeed, today the FDA approves the label “antiperspirant” for any product that reduces axillary sweating by 20% in 50% of users—and no product can be labeled “stops sweating” (Laden K., Ed., Antiperspirants and Deodorants 2nd Edition, 1999).
Numerous commercial over-the-counter and prescription products are useful for controlling excessive sweating in localized areas such as the axilla. Nearly all depend on the well-known antiperspirant action of aluminum chloride hydrate and its cognate derivatives, including the fellow metallic antiperspirant zirconium salts.